Application Form

Join DOM Tech Academy today

Please fill out all the required information below

Parent Information

Please provide your contact details

Parent Type

Mom

Dad

Guardian

Full Name *

Email Address *

Phone Number *

Address *

Children Information

Please provide details about your children

Name

Age

Daily Interests (3-4 words)

Current School

Choose courses for each child

Child 1

Choose your preferred schedules and time slots (you can select multiple)

Perfect for after-school learning

Ideal for evening study sessions

Start your weekend with learning

Flexible weekend learning option

Choose your preferred course package

2x/Week

$289/monthly

3x/Week

$389/monthly

4x/Week

$489/monthly

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Information provided is correct

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